At the same time, technical assistance in adopting and implementing these best practices and in program evaluation has been extended (Johns).

Sex Education Programs -- These include group discussion and emphasize the importance of peer influence (Orecchia, 2009). Research has shown that psycho-educational groups are especially effective in reducing risk behavior among teenage females. Statistics show that young Latina, Native American and African-American girls have higher teen birth rates than whites. First sexual experiences also occur to black females earlier than their white counterparts. The younger they become sexually active, the less likely they use protective means. Practitioners recommend community-based and culturally specific adolescent pregnancy prevention programs for African-American girls younger than 11 or 12. On the other hand, Latina youth need help from staff members who understand Latino culture and speak Spanish. These staff members must emphasize the importance of education to future financial stability among these young girls. Staff members must also be responsive to generational differences and gender roles among Latino families. Intervention with young Native American girls involves trusted family, school and community leaders and greater access to contraceptives (Orecchia).

Practitioners' Perceptions

Qualitative interviews with 58 teenage pregnancy prevention practitioners elicited insights into the realities in implementing culturally sensitive programs (Russell et al., 2004). They work primarily with Mexican-American female teenagers in two regions in California. They consider the knowledge and awareness of Hispanic culture and commitment to the teenagers and their needs essential. They also regard educational and career achievement activities as critical program components. The involvement of the girls' partners and family members are equally important while challenging. At the same time, they observe that implicit program goals of continued education and female self-sufficiency as clashing with traditional Hispanic cultural values. On the whole, respondent-practitioners see the need to balance prevention programs' competing values and goals with those Hispanic culture and experiences (Russell et al.).

Focus on Older Female Teens

Eight out of 10 teen pregnancies and births belong to older teens or those aged 18-19 (Suellentrop, 2010). Pregnancy rates are thrice higher in them than for younger teens. Reported declines were smaller and recent increases are larger in their category. Most of these pregnancies are unplanned and belong to unmarried women. Almost 250,000 births to unmarried older teen women or 83% of all births among 18-19-year-olds were recorded in 2008 alone. Social and economic risks to this age group appear more significant than in those aged 20-21. Children of teen mothers in the 18-19 age group are more likely to be placed in foster care or subjected to abuse or neglect in their first five years. They are also more likely to develop problem conditions in cognition and knowledge, language and communications, social skill and emotional well-being, and physical and motor development. Research furthermore shows that sons of teen mothers in this older teen bracket are more likely to be arrested, imprisoned and stay imprisoned longer than sons of mothers aged 20-21 (Suellentrop).

Teen mothers in this older age bracket are less likely to finish high school and get a diploma than those in the 20-21 age bracket (Suellentrop, 2010). They are also less likely to finish post-secondary education when compared with others who delay childbearing for a few more years. Summarily, children of teen mothers appear to do better if their mothers are slightly older. The chances also appear even better if the pregnancy is wanted and welcomed (Suellentrop).

Findings and Conclusion

The U.S. has the highest teen pregnancy rates in the developed world with approximately 750,000 pregnancies every year, 82% of which are un-intended. A significant decline was recorded from 1995-2002 at 86% due to a correspondingly significant increase in the use of contraceptives. The dominant policy in 87% of public and private schools concerning teen pregnancy is abstinence, which has been noted to be ineffective. Teen pregnancy costs more than $9 billion of taxpayers' money in addition to a range of social and economic burdens on the women, their families, communities and the public. Teen pregnancy rates are highest among non-Hispanic black, Hispanic or Latino, American Indian or Alaska Native and other socially and economically disadvantaged women. According to 2009 figures, 60% of them are 15-19 years old, the majority being in the older 18-19 age group.

A $75 million grant has been made available to prevention programs of 33 States. Ten best practices have been identified. Sex education programs have been conducted. Practitioners have expressed their perceptions and experiences with female teenagers, their characteristics and unique needs. Increased teen pregnancy rates after 2006 indicate that these programs have not been adequate.

Recommendations

A responsive and effective teen pregnancy prevention initiative for professional practice should incorporate the recommendations of practitioners. Culturally specific programs for African-American girls younger than 11 or 12; field workers who are familiar with the Latino culture and can speak Spanish for Latina young women; and trusted family, school and community leaders for young Native American women and greater access to contraceptives for the women should form part of the initiative. Commitment to the young women; their needs; their educational and career achievement activities, the involvement of their partners and their families; and implicit goals of continued education and personal self-sufficiency are also recommended.

The focus should be on older teens in the 18-19 age group, where pregnancy rates are three times higher than younger teens at 250,000 yearly or 83%, according to 2008 figures alone.

Then current policies and strategies may be added, especially those, which have shown positive outcomes. The three-policy strategies -- comprehensive sexuality education, access to contraceptives and reproductive health care, and youth development -- will make valuable contribution. The 10 best practices may be introduced as well, particularly youth development, family involvement, culturally relevant practices, and cooperative extension. The assistance of community-based doulas in the young women's own communities will prove advantageous. And where abstinence may be practiced, it should also be recommended. A comprehensive initiative with all these recommended features should be implemented by all the 33 States under the $75 million grant and then evaluated after a year. A re-adjustment of the features should follow. #

BIBLIOGRAPHY

Breedlove, G. (2005). Perceptions of social support from pregnant and parenting teens using community-based doulas. 14 (3) Journal of Perinatal Education: Lamaze

International Publication. Retrieved on March 18, 2011 from http://www.ncbi.nlm.nih.gov/pmc/article/pmc1595255

CDC 92011). Teen pregnancy in the United States. National Center for Chronic Disease

Prevention and Health Promotion: Centers for Disease Control and Prevention.

Retrieved on March 18, 2011 from http://www.cdc.gov/TeenPregnancy/AboutTeenPreg.htm

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